507 - Understanding Program Efforts to Improve Recruitment of Underrepresented in Medicine Residents to Pediatric Subspecialties Fellowship Programs

Poster Number: 507
Publication Number: 507.125

Blair A. Streater, Boston Children's Hospital, Jamaica Plain, MA, United States; Laura Chiel, Boston Children's Hospital, Boston, MA, United States; Puja Umaretiya, Dana-Farber Cancer Institute, Boston, MA, United States; Alan Schwartz, University of Illinois at Chicago, Chicago, IL, United States; Katie A. A., Dana-Farber Cancer Institute, Boston, MA, United States; jennifer C.. Kesselheim, Boston Children's Hospital, Boston, MA, United States

Background: The pediatric workforce has not achieved representation of diversity that reflects the general U.S. population. Data confirm significant underrepresentation of underrepresented in medicine (URIM) trainees in pediatric subspecialty fellowship programs.

Objective: We aimed to describe: (1) how program directors leverage data regarding applicants’ race and ethnicity in the recruitment process; (2) program strategies to recruit a diverse fellowship class; and (3) perceived barriers and facilitators to the recruitment of a diverse fellowship class.

Design/Methods: In collaboration with the Subspecialty Pediatric Investigators Network, we conducted a national survey of pediatric subspecialty fellowship program directors (FPDs).

Results:

516 FPDs from 15 subspecialties responded, with mean fellowship size of 6 (0-40) fellows. FPDs overwhelmingly agreed that diversity in subspecialty trainees is important (N= 492, 97.4%) and that it improves patient care (N=462, 91.5%). However, race/ethnicity was identified as a top 5 factor influencing the rank list (Table 1) for only 23.8% (N=123) of respondents. FPDs did consider race/ethnicity at multiple time points in the recruitment/selection process, most commonly when creating their rank list (N=293, 56.8%), although 17.8% (N=92) do not consider race/ethnicity at all. The most prevalent facilitators for recruiting a diverse fellowship class are institutional culture (N=303, 60%), addressing diversity with applicants (N=246, 48.8%), and division leadership (N=207, 41.1%). Barriers include number of diverse applicants (N=361, 71.6%), number of diverse faculty (N=288, 57.1%) and virtual recruitment (N=82, 16.3%). The same factors could be both facilitators and barriers (Figure 1). FPDs employ strategies to prioritize diversity in recruitment, most commonly implicit bias training (N=376, 74.5%), featuring diversity, equity, and inclusion (DEI) initiatives on websites (N=305, 60.5%), and featuring program DEI initiatives on interview day (N=242, 48%). Of FPDs who used these strategies, 34.8% (implicit bias training), 27.2% (DEI initiatives on websites), and 43% (featuring DEI initiatives on interview days) thought they were effective, respectively.

Conclusion(s): Diversity in pediatric subspeciality fellowship programs is important to FPDs and is thought to improve patient care. Although strategies are being utilized to recruit URIM fellows, FPDs give only modest ratings to their effectiveness. Increased program sharing of successful initiatives is needed as are resources to tackle identified barriers.